Borderline personality disorder is set apart by the other personalities with traits such as unstable interpersonal relationships with others, erratic mood changes, impulsive behavior, and suicidal tendencies. Individuals with this disorder tend to split, meaning they view people and situations as completely unfair or perfect, which brings about catastrophic mindsets. Causes and symptoms are not limited to childhood abuse, hereditary factors, and negative self-perceptions.
Those with BPD are “treatment seekers” who impede their relationship with therapist with reckless train of thought, distrust, and self-destructive behavior when seeking for help. I will demonstrate the “beginning-to-end” process of a person with BPD by using the five articles to indicate the specific step by step psychological process a patient may encounter. The studies from “Betrayal trauma and borderline personality characteristics: Gender differences” (Kaehler & Freyd, 2012) are replicated from a previous research with a different demographic; in this case, a community sample of 749 with the mean age of 50. , 96% Caucasian, and 80% married as opposed to a group of only college students in the first study. The objective is to link BPD with trauma and insecure attachment styles by using the Betrayal Trauma Theory, which proposes that “individuals may isolate knowledge about betrayals, such as those that occur during maltreatment, in order to maintain a relationship necessary for survival. ” Repressed motions result in developing BPD; the nature of the trauma is heavily emphasized, rather than gender differences.
Kachler and Freyd reused the Brief Betrayal Trauma Survey and Borderline Inventory to find a correlation between borderline tendencies and levels of trauma within the two genders. Men with BPD identified with all levels of betrayal, ranging from low, medium, and high. Women held marks for only medium and high. What I learned that was that although there were three levels for betrayal and trauma, females and males subjectively used different trigger events.
Males indicated near life experiences and accidents, verging on noninterpersonal traumas instead of females who focused on interpersonal trauma, such as being hurt by someone close to them. Women are more susceptible to traumas because women are “socialized to attend to interpersonal relationships more so than men”. Trust and the dynamics of relationships will affect women more than men, who focus on life-threatening aftermaths of an event. Women will tend to be emotionally attached and dependent, which may be reason why BPD is found less in men.
In “The role of defense mechanisms in borderline and antisocial personalities” (Presniak, Olson, & MacGregor, 2010), the article discusses two studies on identifying which defenses are prominent in borderline and antisocial personalities by using two different methods of research to prove that the high comorbidity between the two causes overlapping diagnosis. The studies hoped to distinguish the differences by comparing and identifying major defenses.
Out of 674 candidates, only 428 candidates passed due to incomplete measures of the Personal Assesment Inventory (PAI) and/or Defense Style Questionaire (DSQ), exaggerated negative/positive responding, and inconsistency. Finally, only 72 were diagnosed with antisocial/borderline personalities. The mean age was 20, almost all were Caucasian, and 85% of those with borderline personalities were women. After a MANOVA was conducted, it was discovered that Projecting, Splitting, Acting Out, and Passive Aggression were exceedingly common with those with BPD.
In the second study, 83 out of 1,539 participants were asked to continue the study after the necessary screenings. They were asked to complete the Defense-Q (DSQ) and Expanded Structured Interview (ESI) conducted by multiple coders. After four years of periodic interviews, it revealed that Acting Out, Turning Against Self, and Passive Aggression as the main defenses of BPD, which became variances between borderline and antisocial personalities.
This study is particularly significant in diagnosing patients with a personality disorder because I discovered that the DSM uses a forced-choice test that limits people to choose only between five options of defenses. Upon learning this, it suggests that co-morbidity umbrellas between APD and BPD because without clinical studies or evaluations, it would be hard for therapists to determine which personality disorder their patients have. This means that if there is a diagnosis, more speculation and examination must be present in order to provide an accurate distinction between the two.
This is important because it raises questions on how accurate the DSM is on its own, without the necessity of clinical interviews. When diagnosed, a treatment plan is developed. In the next article, ‘The effectiveness of psychoanalytic-interactional psychotherapy in borderline personality disorder’ (Gerull, Meares, Stevenson, Korner, & Newman, 2008), argues that the Psychoanalytical-Interactional Method (PiM), which focuses on the patient’s idea of self and interpersonal processes. They seek to use interventions in the response mode that can contribute to self-discovery.
In the study, in the clinic of Tiefenbrunn, Germany, 132 patients, which consisted of 86% women, were prescribed to individual and group therapies that were videotaped and reviewed by PiM specialists. The trail lasted an average of 87. 8 days and the mean age was 45. 5. Before and after treatment began, Inventory of Interpersonal Problems, Questionnaire for Contentedness with Life, Questionnaire for Changes in Experiencing and Behavior, and the Symptom Checklist-90–Revised were taken by the patients to order to see correlation and progress.
Specifically, a goal attainment survey was administered to show therapists the specific problems that may be bothering them. After taking the means of all of the tests and surveys, the use of the PiM proved to have worked very well on patients in a span of three years. The areas of improvement were not limited to target/general symptoms, satisfaction with life, and interpersonal problems.
The most crucial thing I learned was that the PiM is also used for other severe disorders. This is note-worthy because it demonstrates the commonality and co-morbidity across disorders. If PiM is also effective as a form of treatment for borderline disorders; this can also be possible for other modes of treatment. However, this greatly emphasizes the unique combinations of both individuals and treatment plans, which require major efforts and consideration to create.
In ‘The Beneficial Effect on Family Life in Treating Borderline Disorder’ (Gerull, Meares, Stevenson, Korner, & Newman, 2008), the study consisted of 45 participants split into a group of 21 individuals who continued with Treatment as Usual (TAU) and another 24 individuals who followed the Conversational Model, which focused on the promotion of “higher order consciousness” or “self” by reflecting on the conversations, or interplay, with the people in their lives to help deal with empathy and self-reflection.
The TAU group had 8 males and 13 females with a mean age of 27. 7. The CM group consisted of 10 men and 14 females and the mean age was 26. 9 years. Other than supervised sessions of CM by certified therapists, the Social Adjustment Scale by Self-Report was administered to measure the details of the patients’ lives, such as social and close relationships and their social and work adjustment. After 12 months, the results of the SAS-SR between the groups were compared, with the CM group having significant improvements than the TAU group.
The CM group had more positive interactions and perceived relationships with their children and significant others, but unscathed towards the nuclear family. This concludes that the Conversation Model made great contributions to those the patients were closest to, meaning that troubled relationships can especially play a role in the development and stronghold of Borderline Personality Disorder. Many persons with BPD cannot be emotionally supportive of their children and lack the responsiveness to the child’s psychological maturation.
Because of that, families of patients are more likely to develop depression, substance abuse, and antisocial disorders. There is emphasis on the impact of one’s environmental, which can explain why there is a lack of empathy in those with BPD because attachment issues and maintaining their relationships with close ones are present. I have learned that through social interactions with the most important people in your lives, people afflicted by BPD are able to develop trust and healthy dependence. Family support is important in maintaining a positive perspective when it comes to treatment.
CM is potentially an important coping strategy for those who struggle with severe cases of BPD. The goals of two previous studies indicate similar goals for the future; both studies aim to find ample treatment between patients and doctor to affirm targets and attack specific obstacles of each individual. Focusing on the patient’s perception of themselves is crucial in the road towards recovery; ‘Recovery in borderline personality disorder (BPD): A qualitative study of service users’ perspectives’ (Katsakou, et al. 2012) seeks to discover the goals and desires of patients who have BPD. There were 48 participants recruited: qualifications were those diagnosed with BPD, over 18, and with a history of self-harm. There were 39 females and 9 males with the mean age of 36. 5, 69% of the group was Caucasian. Semi-structured interviews were the method used in determining the aspirations of the patients. The research team decided on using the core themes from the responses to dissect the patients’ answers.
Many believed that the road to recovery consisted of developing self-acceptance/confidence, better rein on their emotions, improving interpersonal relationships, and avoid resorting to self-harm. Patients expressed that their current treatments were not addressing their personal issues equally. When asked about their recovery, answers varied from “No progress” to “Recovered”. Forty were able to deal with few obstacles and only five felt fully recovered. Some felt that “recovery” was a word with baggage because it suggests fully recovered or still having problems, not defining the lines in-between.
Treatment should establish mutual understandings between the both parties to create a more comprehensive and patient-orientated treatment to encourage long-term goals and needs. What I learned is that treatment can be subjective. Recovery to one person may signify the end of a nightmare or it can also mean impossible. The importance of this research is to show that treatments and people are not black and white. The only aspect lacking from this study is the opinions and views of the therapist administering these sessions.
The importance of a diagnosis can place someone in a box to help clarify which treatments to use, but it is not always the same with every individual. Individuals have subjective definitions on how one should live a satisfying and contributive life “even with the limitations caused by the illness”. How this is reached is not always the same. My articles explain how borderline personality disorder can develop, how professionals can distinguish borderline from other disorders, the factors of the disorder, the effects on close friends and family, treatments and coping mechanisms, and the perceptions of the patient.
The obtained understanding is imperative information, relevant to the disorders in AXIS II because they are described as chronic life-long, and “unchanging”; thus, my research is made to be multifaceted. My lingering question has to do with whether or not BPD is caused by interpersonal relationships since betrayal and family therapy are influential causes and treatments. A trend significant in my readings stated that borderline disorder is one the most difficult to treat, but there are still very high hopes in finding effective treatments.
Another trend is the skewed ratio of gender; all females overreached the amount of men. Can the stereotype of women being overly emotional be explained through the thin emotional shell that borderline personality disorder explains? Further research should see if BPD is possibly factored by the culturally structured perception of women and sensitivity. Another research should revolve around multiple interpersonal relationships that may have caused the overall underlying distrust and perception of people. All five suggest that additional and identical studies are necessary to preserve accuracy.
Gerull, F. , Meares, R. , Stevenson, J. , Korner, A. , & Newman, L. (2008). The beneficial effect on family life in treating borderline personality. Psychiatry: Interpersonal and Biological Processes , 71, 59-70. Kaehler, L. A. , & Freyd, J. J. (2012). Betrayal trauma and borderline personality characteristics: Gender differences. Psychological Trauma: Theory, Research, Practice, and Policy , 4, 379-385. Katsakou, C. , Marougka, S. , Barnicot, K. , Savill, M. White, H. , Lockwood, K. , et al. (2012). Recovery in borderline personality disorder (BPD): A qualitative study of service users’ perspectives. PLoS ONE , 7. Leichsenring, F. , Masuhr, O. , Jaeger, U. , Dally, A. , & Streeck, U. (2010). The effectiveness of psychoanalytic-interactional psychotherapy in borderline personality disorder. Bulletin of the Menninger Clinic , 74, 206-218. Presniak, M. D. , Olson, T. R. , & MacGregor, M. W. (2010). The role of defense mechanisms in borderline and antisocial personalities. Journal of Personality Assessment , 92, 137-145.